Cooperative Agreement H1D3IHS0060

SPECIAL DIABETES PROGRAM FOR INDIANS - THE NAVAJO NATION'S SIZE (AT 27,000 SQUARE MILES, IT IS LARGER THAN 10 US STATES) AND DIVERSE POPULATION - OVER 332,000 PEOPLE LIVING IN 110 CHAPTER COMMUNITIES, MORE THAN 20 BORDER TOWNS, AND MANY URBAN AREAS MEAN THAT PREVENTION AND TREATMENT SERVICES NEED TO REACH A LARGE AREA, WITH TRANSPORTATION, FOOD DESERT, AND RUNNING WATER ARE ALWAYS A KEY CHALLENGE. SINCE 1998, THE NAVAJO AREA INDIAN HEALTH SERVICE (NAIHS) SPECIAL DIABETES PROGRAM FOR INDIANS (SDPI) COMMUNITY-DIRECTED GRANT HAS SUPPORTED LOCAL NAVAJO COMMUNITY, CLINIC, AND HOSPITAL-BASED SITES TO DEVELOP, IMPLEMENT, AND EVALUATE DIABETES PREVENTION AND TREATMENT PROGRAMS BASED ON LOCAL NEEDS, PRIORITIES, AND STRENGTHS. IT HAS ALSO CONTRIBUTED TO SEVERAL NAVAJO AREA-WIDE PROGRAMS FOR PREVENTION AND TREATMENT OF DIABETES. BECAUSE OF THE WIDESPREAD PREVALENCE OF DIABETES AND PRE-DIABETES, AND THE INCREASING RATES OF DIABETES AND ITS RISK FACTORS AMONG CHILDREN, THE NAVAJO COMMUNITY ADVISORY GROUPS AND LEADERS HAVE CONSISTENTLY ADVOCATED THAT NAVAJO IHS SDPI RESOURCES BE DIRECTED TOWARDS PRIMARY PREVENTION AS WELL AS NEEDED CLINICAL SERVICES. LOCAL TRIBAL LEADERSHIP RECOGNIZES THAT THERE IS A GROWING NUMBER OF NAVAJO YOUTHS WHO ARE OVERWEIGHT AND OBESE PLACING THEM AT RISK FOR PRE-DIABETES. IN APRIL 2014, THE NAVAJO NATION COUNCIL AUTHORIZED THE ENACTMENT OF THE HEALTHY DINE NATION ACT OF 2013 TO SUPPORT 110 NAVAJO COMMUNITIES ACROSS THE NAVAJO NATION TO DEVELOP LOCALLY OWNED WELLNESS PROJECTS TO REDUCE THE RATE OF DIABETES ON THE NAVAJO INDIAN RESERVATION. OUR APPLICATION INCLUDES EACH OF THE FIVE FEDERALLY OPERATED NAVAJO SERVICE UNITS AS SUB-GRANTEES WITH THE NAVAJO AREA IHS AS THE PRIMARY GRANTEE. NAIHS SUB-GRANTEES HAVE COMPLETED AND SUBMITTED THEIR 2023 PROJECT NARRATIVES AND BUDGETS TO THE PRIMARY GRANTEE. THE NAVAJO AREA IHS SUBMITTED DOCUMENTS WILL REFLECT THE FIVE SUB-GRANTEES PROJECTS AND AN OVERALL FUNDING BUDGET. THE NAIHS PRIMARY APPLICATION ADDRESSES THE BEST PRACTICE OF PHYSICAL ACTIVITY EDUCATION WITH A FOCUS ON REDUCING THE RISK OF DISEASE, SUCH AS HIGH BLOOD PRESSURE, MANAGE CHRONIC CONDITIONS SUCH AS HEART DISEASE, AND TYPE 2 DIABETES, AND MAINTAIN HEALTHY BODY WEIGHT, QUALITY OF LIFE, AND FEELINGS OF WELL-BEING. THE PHYSICAL ACTIVITY BEST PRACTICE HAS BEEN A PRIORITY OF CHOICE AMONG OUR NATIVE AMERICAN LEADERS AND HEALTH PROMOTION TEAMS WHO STRATEGICALLY DOMINATE THE CHALLENGE TO MAINTAIN COLLABORATIVE MULTI-DISCIPLINARY CONTRIBUTION TO REDUCE AND ELIMINATE THE RISK FACTORS OF CHRONIC DISEASE, CANCER, OBESITY, DEPRESSION, AND SEDENTARY LIVING. THE NAIHS PRIMARY APPLICATION ALSO DESCRIBES OTHER ACTIVITIES AND SERVICES THAT REACH ACROSS THE ENTIRE NAVAJO NATION THAT INCLUDE COMMUNITY-BASED PHYSICAL ACTIVITY PROMOTION, HEALTH COMMUNICATIONS, PROMOTION OF THE NAVAJO WELLNESS MODEL, AND COMMUNITY WELLNESS PLANNING. THE NAIHS SUB-GRANTEE APPLICATIONS FROM EACH OF THE FIVE FEDERALLY OPERATED SERVICE UNITS WILL BE REPORTING ON THE FOLLOWING SDPI BEST PRACTICES: 1. CHINLE SERVICE UNIT - GLYCEMIC CONTROL 2. CROWNPOINT SERVICE UNIT - NUTRITION EDUCATION 3. GALLUP SERVICE UNIT - GLYCEMIC CONTROL 4. KAYENTA SERVICE UNIT - DIABETES-RELATED EDUCATION 5. SHIPROCK SERVICE UNIT - CHRONIC KIDNEY DISEASE SCREENING AND MONITORING THE SERVICE UNIT SUB-GRANTEE APPLICATIONS ALSO DESCRIBE OTHER ACTIVITIES AND SERVICES THAT ARE ALIGNED WITH COMMUNITY AND LOCAL LEADERSHIP PRIORITIES. NAIHS COORDINATES THEIR SERVICE UNIT AND AREA-WIDE ACTIVITIES TO SUPPORT THE EFFORTS OF THE NAVAJO NATION AND SAN JUAN SOUTHERN PAIUTE TRIBES, SO THAT TOGETHER WE CAN MAKE A DIFFERENCE FOR DIABETES PREVENTION AND TREATMENT.